Chronic diarrhea:
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Saunders
2012
|
| Schriftenreihe: | Gastroenterology clinics of North America
41,3 |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | X S., S. 539 - 715 Ill., graph. Darst. |
| ISBN: | 9781455738649 |
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Datensatz im Suchindex
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| adam_text | Titel: Chronic diarrhea
Autor: Hammer, Heinz Florian
Jahr: 2012
?Chronic Diarrhea
Contents
Preface: Chronic Diarrheal Disorders ix
Heinz F. Hammer
The Practical Value of Comprehensive Stool Analysis in Detecting the Cause
of Idiopathic Chronic Diarrhea 539
Karen J. Steffer, Carol A. Santa Ana, Jason A. Cole, and John S. Fordtran
The practical diagnostic value of fecal analysis in the evaluation of patients
with chronic nonbioody diarrhea is controversial. It is possible that varia-
tions in its value depend on how it is done and how the results are inter-
preted rather than on its intrinsic value. In the authors city, stool analysis
has been made easily accessible, with a commitment to quality assurance
and interpretation. To evaluate its practical value, the results of stool anal-
ysis obtained on stool specimens submitted by gastroenterologists were
retrospectively reviewed. The results indicate that stool analysis has sub-
stantial practical diagnostic value in patients with chronic diarrhea.
Colorectal Normal Histology and Histopathologic Findings in Patients with
Chronic Diarrhea 561
Cord Langner
Collagenous and lymphocytic colitis are common causes of chronic wa-
tery diarrhea that are characterized by distinct histopathologic abnormal-
ities without endoscopically visible lesions and are summarized as
microscopic colitis. Several variants of microscopic colitis have been
described, although their clinical significance still has to be defined. Pre-
served mucosal architecture is a histologic hallmark of microscopic colitis
and distinguishes the disease from inflammatory bowel disease (IBD). In
addition to architectural abnormalities, the diagnosis of IBD rests on char-
acteristic inflammatory changes. Differential diagnosis of IBD mainly in-
cludes prolonged infection and diverticular disease-associated colitis,
also known as segmental colitis associated with diverticulosis.
Bacterial Flora as a Cause or Treatment of Chronic Diarrhea 581
Franco Scaldaferri, Marco Pizzoferrato, Silvia Pecere, Fabrizio Forte,
and Antonio Gasbarrini
Intestinal microflora can be considered an organ of the body. It has
several functions in the human gut, mostly metabolic and immunologic,
and constantly interacts with the intestinal mucosa in a delicate equilib-
rium. Chronic diarrhea is associated with an alteration of gut microbiota
when a pathogen invades the gut and also in several conditions asso-
ciated with intestinal mucosal damage or bowel dysfunction, as in in-
flammatory bowel disease, irritable bowel syndrome, or small bowel
bacterial overgrowth. This article discusses the basis of gut microbiota
modulation. Evidence for the efficacy of gut microbiota modulation in
chronic conditions is also discussed.
?vi Contents
Diarrhea Caused By Circulating Agents 603
Elisabeth Fabian, Patrizia Kump, and Guenter J. Krejs
Circulating agents cause intestinal secretion or changes in motility with
decreased intestinal transit time, resulting in secretory-type diarrhea. Se-
cretory diarrhea as opposed to osmotic diarrhea is characterized by
large-volume, watery stools, often more than 1 L per day; by persistence
of diarrhea when patients fast; and by the fact that on analysis of stool-
water, measured osmolarity is identical to that calculated from the electro-
lytes present. Although sodium plays the main role in water and electrolyte
absorption, chloride is the major ion involved in secretion.
Diarrhea Caused By Carbohydrate Malabsorption 611
Heinz F. Hammer and Johann Hammer
This article will focus on the role of the colon in the pathogenesis of diar-
rhea in carbohydrate malabsorption or physiologically incomplete absorp-
tion of carbohydrates, and on the most common manifestation of
carbohydrate malabsorption, lactose malabsorption. In addition, incom-
plete fructose absorption, the role of carbohydrate malabsorption in other
malabsorptive diseases, and congenital defects that lead to malabsorption
will be covered. The article concludes with a section on diagnostic tools to
evaluate carbohydrate malabsorption.
Functional Diarrhea 629
Jan Tack
Chronic diarrhea is a frequent and challenging problem in clinical medi-
cine. In a considerable subgroup of these, no underlying cause is identified
and this is referred to as functional diarrhea. A consensus definition for
functional diarrhea is based on loose stool consistency and chronicity
and absence of coexisting irritable bowel syndrome. Underlying patho-
physiology includes rapid intestinal transit, which may be worsened by
stress or be triggered by a preceding infectious gastroenteritis. Diagnostic
work-up aims at exclusion of underlying organic disease. Treatment starts
with dietary adjustments, aiming at decreasing nutrients that enhance
transit and stool and at identifying precipitating food items.
Celiac Disease 639
Kate E. Evans and David S. Sanders
Celiac disease is common, affecting approximately 1 in 100 people, yet it
remains underdiagnosed. This article reviews our current understanding of
celiac disease, diagnosis, and common pitfalls. Although the cornerstone
of treatment is a gluten-free diet, some patients may still have persisting
symptoms and warrant further investigations.
Diarrhea in Chronic Inflammatory Bowel Diseases 651
Heimo H. Wenzl
Diarrhea is a common clinical feature of inflammatory bowel diseases and
may be accompanied by abdominal pain, urgency, and fecal incontinence.
?Contents vii
The pathophysiology of diarrhea in these diseases is complex, but defective
absorption of salt and water by the inflamed bowel is the most important
mechanism involved. In addition to inflammation secondary to the disease,
diarrhea may arise from a variety of other conditions. It is important to differ-
entiate the pathophysiologic mechanisms involved in the diarrhea in the in-
dividual patient to provide the appropriate therapy. This article reviews
microscopic colitis, ulcerative colitis, and Crohn s disease, focusing on
diarrhea.
Diarrhea in the Immunocompromised Patient 677
Elisabeth Krones and Christoph Högenauer
Diarrhea is a common problem in patients with immunocompromising
conditions. The etiologic spectrum differs from patients with diarrhea
who have a normal immune system. This article reviews the most impor-
tant causes of diarrhea in immunocompromised patients, ranging from in-
fectious causes to noninfectious causes of diarrhea in the setting of HIV
infection as a model for other conditions of immunosuppression. It also
deals with diarrhea in specific situations, eg, after hematopoietic stem
cell or solid organ transplantation, diarrhea induced by immunosuppres-
sive drugs, and diarrhea in congenital immunodeficiency syndromes.
Index
703
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| spelling | Chronic diarrhea guest ed. Heinz F. Hammer Philadelphia, Pa. Saunders 2012 X S., S. 539 - 715 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Gastroenterology clinics of North America 41,3 Hammer, Heinz Florian (DE-588)173729622 edt Gastroenterology clinics of North America 41,3 (DE-604)BV000613725 41,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025359717&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Chronic diarrhea Gastroenterology clinics of North America |
| title | Chronic diarrhea |
| title_auth | Chronic diarrhea |
| title_exact_search | Chronic diarrhea |
| title_full | Chronic diarrhea guest ed. Heinz F. Hammer |
| title_fullStr | Chronic diarrhea guest ed. Heinz F. Hammer |
| title_full_unstemmed | Chronic diarrhea guest ed. Heinz F. Hammer |
| title_short | Chronic diarrhea |
| title_sort | chronic diarrhea |
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